Healthcare Provider Details

I. General information

NPI: 1154284891
Provider Name (Legal Business Name): CEREVIA BEHAVIORAL HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 REGENCY PLZ
GLEN MILLS PA
19342-1001
US

IV. Provider business mailing address

29 REGENCY PLZ
GLEN MILLS PA
19342-1001
US

V. Phone/Fax

Practice location:
  • Phone: 610-203-4259
  • Fax: 610-273-8463
Mailing address:
  • Phone: 610-203-4259
  • Fax: 610-273-8463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ANDREA STAHL
Title or Position: MANAGING MEMBER
Credential:
Phone: 610-364-6856